Applying low-intensity pulsed ultrasounds (LIPUS) to a zoledronate-associated atypical femoral shaft fracture without cessation of zoledronate therapy for 3 years follow up: a case report

被引:4
作者
Arakawa, Shoutaro [1 ]
Saito, Mitsuru [1 ]
Kubota, Makoto [1 ]
Suzuki, Hidehiko [1 ]
Tsuchida, Shigeki [1 ]
Hashimoto, Kurando [1 ]
Marumo, Keishi [1 ]
机构
[1] Jikei Univ, Sch Med, Dept Orthopaed Surg, Tokyo, Japan
关键词
zoledronate; bisphosphonate; breast cancer; malignant skeletal metastasis; atypical femoral fracture; LIPUS;
D O I
10.11138/ccmbm/2015.12.3.269
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Reports are increasing regarding atypical femoral fractures (AFFs) caused by minor trauma in patients using bisphosphonates (BPs) for long periods. Patients with malignant skeletal metastases potentially are at greater risk for these AFFs, especially considering the high dose and the duration of treatment with BPs. We evaluated a case of atypical femoral shaft fracture treated with an intramedullary nail in a patient treated for five years with zoledronate who had breast cancer with metastases to bone. Although bone union was achieved without cessation of zoledronate therapy by applying low-intensity pulsed ultrasounds (LIPUS), the remodeling phase of the fracture healing process was delayed. For BPs-associated AFFs, LIPUS is an alternative to parathyroid hormone (PTH) analogs such as teriparatide that are contraindicated in patients with malignant skeletal metastases. LIPUS is an effective treatment for fracture healing and may avoid the necessity to discontinue BP therapy.
引用
收藏
页码:269 / 272
页数:4
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